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Individual

MR. SCOTT ROBERT HAERTEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC, CSCS

Contact information

Practice address
3420 BLUE RIDGE DR, CARPENTERSVILLE, IL 60110-3601
(702) 217-5505
Mailing address
3420 BLUE RIDGE DR, CARPENTERSVILLE, IL 60110-3601
(702) 217-5505

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096000997
IL

Other

Enumeration date
03/08/2010
Last updated
03/08/2010
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